Lipoma Surgery in Jaipur

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What is a lipoma?

Rather soft, of variable size, the lipoma is a mass of subcutaneous fat . Completely benign, this excess fat located under the epidermis can measure between 1 and 20 cm , sometimes more, and form anywhere on the body: stomach, arms, breast, back ... but also brain, muscles, tendons , bone! No area of ​​our anatomy is immune to a lipoma! For now, although we know the mechanism behind the formation of a lipoma, the runaway cells of fatty tissue, we do not know what causes this excessive proliferation.

Is it serious ?

If the lipoma is inherently harmless to health, certain locations can have serious consequences. This is more particularly the case of lipomas which develop in depth, near organs or those which reach a critical size, indicates Professor Lorette. "A lipoma located in the brain, on a muscle, a tendon or a bone can cause compression of the vessels or nerves nearby and cause pain or even paralysis" , describes the dermatologist.

The circumscribed lipomas

They are located in subcutaneous cell tissue or in a muscle . The neck , back , shoulders and thighs are the most commonly affected areas. These lipomas can be single or multiple: in the latter case, it is a question of lipomatosis .

It can be found in deep organs, for example the small intestine .

How to be sure that it is a lipoma?

Only a general practitioner or a dermatologist can diagnose a lipoma. Palpation of the lump is usually sufficient to diagnose and distinguish the lipoma from another lump: soft, malleable, the lipoma has regular contours and rolls under the fingers. The sebaceous cyst , with which it is often confused by patients, looks like a hard lump with a hole in the middle. If in doubt, the doctor can take a biopsy and have the sample analyzed.

Lipomas usually grow independently of any disease. However, they can be part of the symptoms of certain pathologies.

• This is the case with Dercum's disease, a rare condition that affects obese people , especially women. Also known under the term painful adiposis, it is characterized by the presence of multiple painful lipomas in the lower limbs, difficult to relieve, which have the unfortunate tendency to reform after their removal.
• The lipomatosisis characterized in turn by multiple lipomas, organized and thorough. This genetic disease, of which Launois-Bensaude disease is a part , occurs in two forms: with lipomas concentrated in the neck and trunk area and symmetrically dispersed (this is the form that mainly affects men suffering from comorbidities such as diabetes , high blood pressure and alcoholism );  with lipomas present in the abdomen and at the roots of the thighs, where they can be troublesome and exert pressure on the surrounding vessels, nerves and muscles.

Treatment of a lipoma

Lipoma rarely requires treatment . But if it becomes painful or if its unsightly appearance bothers patients, then its removal is indicated. The intervention is done by outpatient surgery (without hospitalization): this is the most appropriate technique. Avoid, on the other hand, liposuction techniques that are accompanied by a high rate of recurrence, warns the specialist.

Treatment

Normally, treatment for a lipoma is not necessary unless it restricts movement or the tumor becomes painful. The removal is usually done for cosmetic reasons, if the tumor is growing strongly. A tissue diagnosis, histopathology , is also a cause of withdrawal to check if we are not in the presence of a tumor of the liposarcoma  type .

A simple excision is normally sufficient to remove a lipoma. The operation is done under local anesthesia and takes less than 30 minutes. It treats the majority of cases with a reappearance of the lipoma in 1-2% of cases after excision . The liposuction is another option.

How to properly treat a lipoma?

Lipoma is the most common benign tumor in humans. A lipoma can be found anywhere where fatty tissue is present. The causes of these lesions are unfortunately not defined. There are, however, some cases of familial multiple lipomatosis. The lipoma is made up of mature adipocytes and is often surrounded and delimited by a thin capsule. In most cases, the lipoma easily deletes from surrounding tissue. It is soft and very mobile. However, especially in the neck and shoulder area, it can contain hard collagen fibers and form clusters that adhere firmly to adjacent tissues. Since the lipoma is benign in nature, resection is not always necessary.It should be reserved for lesions which are symptomatic or which obviously deform the surface of the skin. In addition, one should be wary of a lipoma which progresses rapidly or whose diameter is greater than 5 cm, as the diagnosis may well be different (liposarcoma or other malignant lesion of the subcutaneous tissues). Exeresis is therefore necessary from the outset in these situations.
The excision technique is rather simple. A simple transverse incision is made opposite the lesion. In the case of a simple small lipoma, enucleation is easily done using hemostats. If the lipoma is larger or poorly defined, then careful dissection with a scalpel or scissor is necessary. Make sure that the entire lesion has been excised. The color, texture, and appearance of the fat in a lipoma usually differ sufficiently from that of adjacent normal tissue that it is relatively easy to check the quality of the resection. The wound is closed in a standard way, except if the lipoma is large, and leaves a large residual cavity.It is then suggested to leave a drain for 24 to 72 hours to avoid the accumulation of serum or blood in the dissection cavity.

Cysts

Skin cysts are commonplace in the practice of any general practitioner. They are easily recognized: they are subcutaneous nodules, more or less voluminous, firm, which can be disseminated all over the body. They are often called sebaceous cysts. However, this term is incorrect, as the content of these cysts is most often keratin and not sebum. There are several forms of skin cysts, despite their similar appearance in the clinic. All these cysts are subcutaneous and create a more or less marked protuberance on the surface of the skin. They consist of an envelope (or shell) filled with a variable amount of whitish and often smelly substance. The envelope consists of a layer of epidermis overlooking the internal cavity of the cyst,with deeper layers receding towards the periphery. It is in the composition of the deeper layers that the different kinds of cysts are distinguished.